Roberts Janet, O'Rielly Darren D, Rahman Proton
Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Faculty of Medicine, Memorial University of Newfoundland, St John's, Newfoundland & Labrador, Canada.
Immunotherapy. 2018 Apr;10(5):361-372. doi: 10.2217/imt-2017-0149. Epub 2018 Feb 14.
Psoriatic arthritis is an inflammatory arthritis associated with psoriasis. The IL-23/IL-17 axis is an important pathway in the development of psoriatic disease. Ustekinumab is a fully human monoclonal IgG1 antibody that binds to the p40 subunit of IL-12 and IL-23, which, in turn, inhibits downstream signaling pathways. PSUMMIT-1 and PSUMMIT-2 are two pivotal Phase III trials demonstrating global improvement in primary and secondary outcomes including inhibition of radiographic progression. Therapeutic benefit of ustekinumab for synovitis appears independent of previous disease modifying antirheumatic disease or anti-TNF exposure. At present, the data support the use of ustekinumab in the treatment of psoriatic arthritis after the failure of NSAIDs and conventional disease modifying antirheumatic diseases as an alternative to, or after failure of an anti-TNF agent.
银屑病关节炎是一种与银屑病相关的炎性关节炎。白细胞介素-23/白细胞介素-17轴是银屑病疾病发展中的一条重要途径。优特克单抗是一种完全人源化的单克隆IgG1抗体，它与白细胞介素-12和白细胞介素-23的p40亚基结合，进而抑制下游信号通路。PSUMMIT-1和PSUMMIT-2是两项关键的III期试验，证明在包括抑制影像学进展在内的主要和次要结局方面有整体改善。优特克单抗对滑膜炎的治疗益处似乎独立于先前使用的改善病情抗风湿药或抗TNF治疗。目前，数据支持在非甾体抗炎药和传统改善病情抗风湿药治疗失败后，将优特克单抗用于治疗银屑病关节炎，作为抗TNF药物治疗失败后的替代治疗或在抗TNF药物治疗失败之后使用。
